Generic medications and blood pressure control in diabetic hypertensive subjects

Academic Article


  • OBJECTIVEdTo investigate temporal improvements in blood pressure (BP) control in subjects with diabetes and policy changes regarding generic antihypertensives. RESEARCH DESIGN AND METHODSdIn a cross-sectional study we used logistic regression models to investigate the temporal relationship between access to generic antihypertensivemedications and BP control (,130/80mmHg) in 5,375 subjects (mean age, 6669 years; 61% African American) with diabetes and hypertension (HTN) enrolled in the national Results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study between 2003 and 2007. At enrollment, BP was measured and medications in the home determined by medication label review by a trained professional. Generic antihypertensive medication status was ascertained from the U.S. Food and Drug Administration. RESULTSdThe percentage of subjects accessing generically available antihypertensive medications increased significantly from 66% in 2003 to 81% in 2007 (P, 0.0001), and the odds of achieving a BP ,130/80 mmHg in 2007 was 66% higher (odds ratio 1.66 [95% CI 1.30-2.10]) than in 2003.Nevertheless,50%of participants achieved this goal. African American race,male sex, limited income, and medication nonadherence were significant predictors of inadequate BP control. There was no significant relationship between access to generic antihypertensives and BP control when other demographic factors were included in the model (0.98 [0.96-1.00]). CONCLUSIONSdAmong African American and white subjects with HTN and diabetes, BP control remained inadequate relative to published guidelines, and racial disparities persisted. Although access to generic antihypertensives increased, this was not independently associated with improved BP control, suggesting that poor BP control is multifactorial. Copyright © 2013 by the American Diabetes Association.
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    Author List

  • Cummings DM; Letter AJ; Howard G; Howard VJ; Safford MM; Prince V; Muntner P
  • Start Page

  • 591
  • End Page

  • 597
  • Volume

  • 36
  • Issue

  • 3